前睫状巩膜切开矫治老视的疗效评估

Assessment of anterior ciliary sclerotomy treating presbyopia

目的 :验证前睫状巩膜切开术矫治老视的疗效并探讨其可能的机制。方法 :对 2 2只老视眼行前睫状巩膜切开 ,评估手术后的视功能及调节改变 ,并用A超对手术眼与对照眼的前节变化作对比研究。结果 :手术后近期平均近视力由 0 2增至 0 6,近点则由 ( 64 1± 2 6 6)cm缩短至 ( 2 0 8± 4 5 )cm。调节时晶状体厚度增加。16眼随访 2～ 5年 ,近视力普遍下降 1行 ,保持在术后 3个月水平 ( 0 4～ 0 6)。结论 :前睫状巩膜切开能使老视眼近视力改善 ,但疗效不理想。近视力的改善源於巩膜扩张后睫状体与晶状体赤道部距离增宽 ,导致调节时晶状体厚度增加。但该手术不能完全矫正老视状态。

Objective:To determine the efficiency of anterior ciliary sclerotomy(ACS) for the treatment of human presbyopia and to investigate the possible mechanisms. Methods:22 patients with presbyopia were involved,one eye underwent ACS and the others as control.The visual performance and objective accommodation amplitude were evaluated.The changes in anterior segments of the two groups were measured by A-scan ultrasonography. Results:One month after surgery the average near vision of ACS group was increased from 0 2 to 0 6,near point reduced from 64 1±26 6cm to 20 8±4 5cm.The increasing in lens thickness was obvious during accommodation.16 eyes were f0llowed-up for 24～60 months,the near vision kept at 0 4～0 6. Conclusions:The near vision can be improved with ACS in all the prosbyopic eyes.